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Billing code

A198A — Consultative Interview On Behalf Of Disturbed Patient (including Report) - Consultative Interview With Patient Less Than Age 22

Psychiatric interview, patient under 22

A psychiatrist bills A198 for a consultative interview, with report, with a disturbed patient under age 22.

Watch for: Only for patients under 22, and it is a consultation, so enter the referrer's six-digit billing number from the written request.

Code

A198A

Description

Consultative Interview On Behalf Of Disturbed Patient (including Report) - Consultative Interview With Patient Less Than Age 22

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Psychiatrist's consultative interview, with report, with a disturbed patient under age 22. It is a consultation and needs a written referral.

What it covers

A198 is a Psychiatry (19) consultative interview with a disturbed patient younger than 22, including a report (A184). A disturbed patient is someone with a clinically significant disturbance in cognition, emotional regulation or behaviour that limits their ability to give a reliable and complete history (A184).

A198 is a consultation (A184), so it follows a written request from a referring physician, nurse practitioner or dental surgeon and includes the written report to the referrer (GP16). The interview with the parents or representatives of the same patient is A197.

Billing rules

• Patient must be less than 22 years of age. For a patient 65 or older, or under 65 with dementia, the code is A192 (A184).
• Needs a written, signed request naming the consultant or specialty, the referrer and billing number, and the patient and health number, kept in the chart; otherwise it is paid as a lesser assessment (GP16).
• Consultation limits apply: one per patient per physician per two consecutive 12-month periods for the same diagnosis, one per 12 months for a clearly unrelated diagnosis; extras are paid as an assessment (GP17, GP18).
• Not payable for the same patient on the same day as K191, K193, K195 or K196 (A184).
• Detention (K001) is not payable the same patient, same day (GP31). K630 extension starts after 60 minutes as a sole service, or 120 minutes when A197 and A198 are both billed for the patient that day (A185).
• K189 urgent community psychiatric follow-up may be added for an out-patient seen urgently within four weeks of a psychiatric in-patient discharge, when you didn't treat the patient in that admission and will follow them for at least six months; maximum one per physician per patient per 12 months, and K188 is not payable with K189 the same day (A188).
• A198 is a consultation (A184 note 1), so the GP64 age premium for specialist consultations applies when the patient is under 16: 10% (age 5 to 15) up to 30% (under 30 days) (A184, GP64).
• Video only (with K300A), never telephone (AJ2).

Often billed with

• A197, the interview with the patient's parents or representatives, for the same patient on the same day (A185).
• K630 psychiatric consultation extension once the minimum time has passed (A185).
• K188 (+15%) within six months after a suicide attempt, or K189 after a recent psychiatric discharge; not both on the same day (A188).
• K300A when the interview is done by video (A70, AJ2).

Common rejections

• A2A: A198 is only for a patient under 22 (A184); OHIP's record showed the patient was 22 or older on the service date. Check the date of birth on the claim, or use A192 for a patient 65+ or with dementia.
• AC4: A198 is a consultation (A184), so it needs a valid referring provider number. The number was missing, mistyped, your own, or from a provider type that can't refer; enter the referrer's six-digit number from the written request (GP16).
• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated (GP9).
• A4D: The code is in the Psychiatry (19) listing, and specialists bill from their own specialty's listing (GP9). The specialty on the claim can't bill it.

Related codes: A197, A192, A191, A195, K630, K188, K189, K196

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), Consultative interview on behalf of disturbed patient, page A184; K630 table on A185; premiums on A188; General Preamble GP16 to GP18 (consultations), GP31 (detention), GP64 (age premiums)

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